恩替卡韦治疗慢性乙型肝炎合并非酒精性脂肪性肝病的临床疗效

Clinical efficacy of entecavir in the treatment of chronic hepatitis B with nonalcoholic fatty liver disease

目的探讨恩替卡韦治疗慢性乙型肝炎合并非酒精性脂肪性肝病的临床疗效。方法选取2020年1—6月中国人民解放军联勤保障部队第九一〇医院收治的92例慢性乙型肝炎合并非酒精性脂肪性肝病患者,以统计学软件SAS将其随机分为两组,每组各46例。对照组以常规方案治疗,观察组采用恩替卡韦治疗,对比两组患者疗效、血清实验室指标、肝功能、肝组织脂肪变化。结果观察组治疗总有效率为95.65%(44/46),明显高于对照组的76.09%(35/46),差异有统计学意义(P<0.05)。治疗前两组患者血清实验室指标Ⅲ型前胶原、Ⅳ型胶原蛋白、层粘连蛋白、透明质酸酶比较,差异均无统计学意义(P>0.05);治疗后观察组上述指标均低于对照组,差异有统计学意义(P<0.001)。治疗前两组患者谷草转氨酶、谷丙转氨酶指标比较,差异均无统计学意义(P>0.05);治疗后观察组谷草转氨酶、谷丙转氨酶均低于对照组,差异有统计学意义(P<0.001)。治疗后观察组肝组织脂肪变化F0比例高于对照组,差异有统计学意义(P<0.05)。结论恩替卡韦治疗慢性乙型肝炎合并非酒精性脂肪性肝病疗效出众,可有效改善患者血清实验室指标及肝功能,调节肝组织脂肪代谢,应用价值较高。

Objective To investigate the clinical efficacy of entecavir in the treatment of chronic hepatitis B with nonalcoholic fatty liver disease(NAFLD).Methods A total of 92 patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease admitted to No.910 Hospital of the PLA Joint Logistics Support Forcehospital from January to June 2020 were selected.The patients were randomly divided into two groups by statistical software SAS,with 46 cases in each group.The control group was treated with a conventional regimen,and the observation group was treated with entecavir.The treatment efficacy,serum laboratory parameters,liver function,and liver tissue fat changes were compared between the two groups.Results The total effective rate of treatment was 95.65%(44/46)in the observation group,which was higher than that of 76.09%(35/46)in the control group,with significant difference(P<0.05).Before treatment,there were no significant differences in serum laboratory indicators of typeⅢprocollagen,typeⅣcollagen,laminin,and hyaluronidase between the two groups(P>0.05).After treatment,the above indicators in observation group were lower than those in the control group,with significant difference(P<0.001).There was no significant difference in aspartate aminotransferase and alanine aminotransferase before treatment between the two groups(P>0.05).After treatment,aspartate aminotransferase and alanine aminotransferase in the observation group were lower than those in the control group,with significant difference(P<0.001).After treatment,the fat change percentage F0 of liver tissue in the observation group was higher than in the control group,with significant difference(P<0.05).Conclusion Entecavir has an excellent curative effect in treating chronic hepatitis B with nonalcoholic fatty liver disease.It can effectively improve the serum laboratory parameters and liver function,regulate liver tissue fat metabolism,and has a high application value.